The elevation angle of the vagina (EAV) following different pelvic reconstructive procedures

Objective:

To compare the anatomical elevation angle of the vagina (EAV) following four different pelvic floor reconstructive procedures.

Methods:

A postoperative MRI was performed following four different pelvic reconstructive procedures: classical sacrospineous fixation, high medial sacrospineous fixation, laparoscopic sacrocolpopexy and triple fixation sacropectopexy. Postoperative MRI of 30 patients from each of the four procedures were evaluated and the vaginal angle from the pelvic diagonal conjugate was measured. A lower EAV is represented by larger angle from the pelvic diagonal conjugate.

Results:

The classical sacrospineous fixation had the lowest EAV, followed by high medial sacrospineous fixation, laparoscopic sacrocolpopexy and triple fixation sacropectopexy respectively.

Conclusion:

We were able to objectively demonstrate that different pelvic floor reconstructive procedures result in different EAV. This information may be significant for properly tailoring the type of procedure for each patient.

Abb. 1: Elevation angle of the vagina